Tuberculosis Mark Oette Klinik fr Allgemeine Innere Medizin, - PowerPoint PPT Presentation

Tuberculosis Mark Oette Klinik für Allgemeine Innere Medizin, Gastroenterologie und Infektiologie Krankenhaus der Augustinerinnen, Köln

Conflicts • This presentation is free of financial interests • Speech honoraria of the last 3 years BMS Falk Gilead Heinen & Löwenstein Hitachi Krankenhäuser

Tbc worldwide

Europe: Transm issible Diseases Inzidence-based DALY/ 100.000, 2009-2013 (1.4 Mio, every 14th person) Cassini A. Eurosurveillance 2018; 23: pii= 17.00454

Europe: Tbc Notification Rate

Tuberculosis Incidence Germany (RKI 2018)

Lung Tbc and Nationality (RKI 2015)

Nationality: Italy

Tuberculosis, Age, and Gender (RKI 2018)

Diagnostics (RKI 2015)

Mortality (RKI 2018)

Resistance (RKI 2018)

Resistance: Italy

Resistance (RKI 2018)

Lange C, et al. Respirology 2018; 23: 656-673

Resistance (MDR)

Europe: Tbc MDR-Rate

Sequencing for Resistance Mutations • Evaluation of 5 software tools to predict resistance (n= 211), 2014 • Comparison with growth cultures/ phenotypic resistance testing • WGS: Illumina MiSec System • Software tools : PhyResSE, Mykrobe Predictor, TB Profiler, TGS-TB and KvarQ • Results: Sensitivity: 74-80% ; Specificity: > 95% Considerable variation between individual drugs Turnaround time (median): 5 vs. 19 days Van Beek J. Clin Microbiol Infect 2019; 25: 82-86

Summary  In Germany approx. 5500 affected persons, slow decline  Epidemiology still driven by migrants  Resistance: Significant problem, rising (not in G)  Transmission of resistance  MDR: Relevant for survival  Resistance testing: Procession time suboptimal  Molecular resistance testing: New applications underway  The future: Resistance testing by NGS standard

Thank you !

Resistance